The Advisory Committee on Immunization Practices (ACIP) from the Centers of Disease Control and Prevention (CDC) has issued its recommended immunization schedule for adults aged ≥19 years in the US. Changes in the 2018 adult immunization schedule from the previous year’s schedule include new ACIP recommendations on the use of recombinant zoster vaccine (RZV) to prevent shingles in adults aged ≥50 years and the use of an additional dose of measles, mumps, and rubella vaccine (MMR) in a mumps outbreak setting. The update includes the following recommendations:

The change in recommendation to preferential use of RZV (Shingrix) is a large and exciting one. It is large because the recommendation begins at age 50, an age where we are not currently used to recommending vaccination, so it will take a concerted effort to integrate this into practice. It is also large because it has the potential to benefit many people given the much better efficacy of RZV in preventing shingles than the previous vaccine. Vaccination in adults is an important area to emphasize, as vaccination coverage rates for adults in the US are lower than they should be. For those eligible for vaccination, current rates of vaccination are: influenza (45%); Tdap (23%); zoster (31%). —Neil Skolnik, MD